Factors impeding switching from clozapine to paliperidone among patients with chronic schizophrenia-A retrospective...

Clozapine is an old antipsychotic that is effective for schizophrenia, however undesirable side effects affect drug adherence. The present study aimed to investigate the predictors for failed switching from clozapine to paliperidone (FSCP) among patients with chronic schizophrenia. This 9-year (January 2010-December 2018) retrospective study included 78 individuals with schizophrenia who wished to switch from clozapine to paliperidone and resided in a nursing home in Taiwan. The univariate Cox proportional hazards regression model (Cox model) was applied to estimate the potential factors for subsequent FSCP, followed by a multivariate Cox model to determine significant predictors of FSCP after adjusting for other covariates. Thirty eight of the 78 participants (48.7%) failed to switch from clozapine to paliperidone. After forward selection in the Cox hazard regression model, a higher number of total admission days during 1 year before switching, longer duration of clozapine use before switching, and higher average daily dose of clozapine during 1 year before switching were significantly associated with FSCP. It is suggested that clinicians should discuss with their patients about the risk factors if they intend to switch from clozapine to paliperidone. Further studies are warranted to verify our findings and extend the applicability. (PsycInfo Database Record (c) 2022 APA, all rights reserved).